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严重的低血压,但不是全身性炎症或内皮激活,预测在循环冲击中的脑病变

Duc Nam Nguyen¹, Luc Huyghens², Truc Mai Nguyen³

¹Department of Critical Care Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.

Annals of intensive care

|March 6, 2026

概括

循环休克会导致脑病变,其特征是昏迷和妄想. 严重的低血压和神经炎症标志物,而不是系统性炎症,是重症患者脑病变的主要驱动因素.

科学领域:

关键护理医学关键护理医学
神经学神经学
科研重症监护室 (ICU) 科研重症监护室

背景情况:

脑病是循环休克的常见并发症,与患者的不良结果有关.
休克时脑病变的确切原因,包括系统性炎症,内皮细胞激活或大脑低 perfusion,仍然不清楚.

研究的目的:

在经历循环休克的患者中调查脑病变的主要驱动因素.
区分神经炎症,内皮激活和严重低血压在脑病变的发展中的作用.

主要方法:

对198名患有循环休克 (败血和非败血) 的ICU患者的回顾性分析.
使用格拉斯哥昏迷量表,里士满兴奋镇静量表和ICU的混乱评估方法来评估脑病.
测量了神经炎症 (S100B),全身炎症 (CRP,MMP-9) 和内皮激活 (ICAM-1,VEGF). 严重的低血压被定义为平均动脉压 (MAP) <50 mmHg.

主要成果:

在71%的患者中发生脑病变,其中23%的患者经历昏迷和71%的 Delirium.
严重的低血压 (MAP <50 mmHg),长时间的镇静,ICU获得的感染和升高的S100B与脑病变有显著的关联.
系统性炎症标志物 (CRP,MMP-9) 和内皮激活标志物 (ICAM-1,VEGF) 与脑病变无关.

结论:

重复重度低血压 (MAP <50 mmHg) 和神经炎症标志物是循环休克中脑病变的最强预测因素.
系统性炎症和内皮激活似乎不是这种患者群体中脑病变的主要驱动因素.

关键词:

循环冲击是因为循环的冲击.脑病变是一种脑病变.内皮细胞激活是什么血压下降血压下降血压下降炎症炎症是一种炎症.在S100B蛋白质中,S100B蛋白质是

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